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The prognosis for independent breathing for patients with lesions above C4 is poor, especially if they do not breathe during the first 24 hours of life.

Infarcts
Spinal cord infarcts are rare. They usually occur in newborns with umbilical artery catheterization in whom the catheter tip is placed too high in the umbilical artery. They rarely occur in premature neonates without an apparent predisposing problem. Placing the tip of the catheter at or above T10 and T12 may lead to obstruction of the artery of Adamkiewicz. This artery is the major segmental artery of the spinal cord. Spinal infarct due to obstruction of the artery of Adamkiewicz initially produces generalized hypotonia with decreased dynamic tone followed by spastic paraparesis as a result of damage to the corticospinal fibers destined to innervate the lumbosacral motor neurons.

 

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Barkovich, 1995